Heavy alcohol use negatively impacts memory, reasoning, and brain function. In particular, regularly drinking four or more alcoholic drinks per day increases a person’s risk of hippocampal shrinkage by almost six times compared to nondrinkers. For reference, the "hippocampus" is the part of your brain that stores memories and aids in learning.
Excessive alcohol use is also linked to depression, anxiety, mood disorders, and self-harm (e.g., suicide and cutting).
The following factors determine to what extent alcohol negatively impacts the brain:
Alcohol abuse changes your brain’s chemistry. Therefore, it can lead to both short- and long-term psychological issues, including:
Temporary psychological effects of alcohol
Serious psychological effects of alcohol
Alcohol limits the brain’s ability to transfer information from your short-term memory to long-term storage. This is because heavy alcohol use changes your neurons, which results in smaller brain cells. Over time, and with continued alcohol use, it becomes more difficult to remember previous experiences and simple daily tasks.
Additionally, long-term alcohol use is linked to many serious memory disorders. A few common disorders include:
As mentioned above, alcohol shrinks the brain and decreases the size of brain cells. People who have an alcohol use disorder (AUD) appear to have smaller brains than moderate and non-drinkers. AUD (previously called alcoholism) is a severe and chronic disorder that results in an uncontrollable dependence on alcohol. Symptoms of brain atrophy include:
Some researchers believe Wernicke and Korsakoff syndromes are separate yet related disorders. Others believe them to be different stages of the same disorder or disease spectrum. Wernicke syndrome is considered the acute phase with a shorter duration and more serious symptoms. Korsakoff syndrome is considered the chronic phase and is a long-lasting condition.
Both of these conditions develop suddenly due to thiamine deficiency. In many cases, those with AUD are deficient in vitamin B1. So, they have a higher risk of developing these disorders.
Wernicke syndrome is characterized by the clinical triad of mental status changes (e.g., confused state), the inability to coordinate voluntary movement (ataxia), and eye abnormalities. Affected individuals may not display all three symptoms. Other signs of Wernicke’s include:
If Wernicke’s syndrome is left untreated, Korsakoff syndrome will likely develop. Korsakoff psychosis forms due to permanent damage in critical small areas deep within the brain.
Korsakoff syndrome is characterized by memory impairment, specifically short-term memory loss (i.e., the inability to form new memories). In some cases, affected individuals may also have random loss of long-term memories. In rare cases, individuals may create imaginary events to fill in gaps in their memory (confabulation).
Similar to Korsakoff syndrome, alcoholic dementia is a form of alcohol-related brain damage that results in memory loss. However, symptoms of Korsakoff syndrome are typically more severe than those associated with alcoholic dementia.
Long-term alcohol abuse directly impacts brain function and alters your brain chemistry (neurotransmitters). In addition, alcohol affects the hormonal systems in your body that are associated with common mental health conditions. Due to alcohol’s depressive effect, those with AUD also have a higher risk of attempting suicide and engaging in self-harm.
Common mental health disorders associated with heavy alcohol use include:
Depression, which is a group of conditions that lower a person’s mood, affects about 80 percent of alcoholics at some point. Depression comes in many forms, including clinical depression, persistent depressive disorder, and bipolar disorders, among others. The effects can come in waves throughout life or be long-term.
Since alcohol is a depressant, the substance enhances the symptoms of depression due to its sedative effects.
One study found that 25 percent of people experience depression after binge drinking (consuming a large amount of alcohol quickly). About 33 to 50 percent of people with AUD also struggle with depression.
Anxiety is a common condition that leads to constant worrying about daily situations. Alcohol-induced anxiety is separate from an independent anxiety disorder, but they are often hard to differentiate. Although, the symptoms of alcohol-induced anxiety usually appear during alcohol withdrawal. They also tend to resolve quickly with treatment and continued abstinence.
Certain anxiety disorders, including social phobia, PTSD, and panic disorder, have an increased co-occurrence with alcohol dependence. Many people abuse alcohol to suppress the symptoms of their anxiety disorder temporarily. What many people do not know, however, is that alcohol abuse makes anxiety worse. Alcohol use also has high rates of producing panic attacks, which can turn into panic disorder.
Alcohol is a depressant. It is also linked to many mental health disorders, such as depression. As a result, the risk of self-harm is high among alcoholics. This may include self-inflicted injuries, such as cutting, or suicide.
People with AUD are 60 to 120 times more likely to participate in self-harm and commit suicide than those free from psychiatric illness.
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Alcohol’s Damaging Effects On The Brain. U.S. Department of Health & Human Services. October 2004. https://pubs.niaaa.nih.gov/publications/aa63/aa63.htm
“Korsakoff's Syndrome.” Alzheimer's Society, www.alzheimers.org.uk/about-dementia/types-dementia/korsakoffs-syndrome.
Merz, Beverly. “This Is Your Brain on Alcohol.” Harvard Health Blog, 13 July 2017, www.health.harvard.edu/blog/this-is-your-brain-on-alcohol-2017071412000.
Ramesh S., M.D., et al. Alcoholism and Psychiatric Disorders. Alcohol Research & Health. 2002;26(2): 90-98. https://pubs.niaaa.nih.gov/publications/arh26-2/90-98.htm
Ritchie, Craig, and Abel Koshy. “Faculty of 1000 Evaluation for Moderate Alcohol Consumption as Risk Factor for Adverse Brain Outcomes and Cognitive Decline: Longitudinal Cohort Study.” F1000 - Post-Publication Peer Review of the Biomedical Literature, 2018, doi:10.3410/f.727689951.793543102, https://pubmed.ncbi.nlm.nih.gov/28588063/.
“Symptoms of Alcoholic Dementia.” Alzheimer's Society, www.alzheimers.org.uk/about-dementia/types-dementia/alcoholic-dementia.